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There are significant problems with the mechanisms by which conflicts of interest are currently managed and governed. In our view, finder''s fees and other controversial issues in research have often been de-tit with in isolation, and in a way sheltered from analyses which would open up the possibility of "legal interference." Discussions about finder''s fees and other recruitment incentives are often oriented solely by reference to institutional, national, and international ethics guidelines. They remain curiously silent on the parties'' legal obligations and potential legal sanctions. This reflects and encourages inordinate reliance on the overly general conflicts of interest rules in ethics guidelines, and on the inadequately regulated American (or largely unregulated Canadian) system of IRB review. Some legislated standards of professional conduct and court rulings provide much more stringent benchmarks for the behavior of physicians in research, but these have been largely ignored and inadequately enforced. This paper aims to create awareness of the seriousness of the issues surrounding finder''s fees, and to detail relevant ethical, legal, and policy standards. We argue that stricter oversight of conflicts of interest by institutional and regulatory authorities, and better enforcement of existing regulatory and legal remedies are needed to safeguard the rights and well-being of research subjects and to preserve the integrity of the medical profession and the research process. In addition, we point out that instances of concealed profiteering from research recruitment activities could attract criminal sanctions. This alone highlights the importance of professional organizations and funding and regulatory agencies turning their full attention to the development of adequate controls for recruitment activities.

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